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Medem, Inc. 649 Mission Street 2nd Floor San Francisco, CA 94105 Tel 415-644- 3800 Fax 415-644-3950 www.medem.com Request for Proposal (RFP) Outsourced Software Development and Maintenance Services Contact: E-mail (use this e-mail for all question, communications and submissions): David Aaronson, Project Manager david.aaronson@medem.com RFP Released: 5/16/2007 Proposal Must be submitted No Later Than: 5/31/2007

Confidentiality This Request for Proposal has been prepared by Medem, Inc (Medem) and is being provided to present you with an opportunity to bid. The information enclosed in this proposal is proprietary to Medem. Medem is not conveying any ownership, or agreement to enter a partnership to any party by disclosing this information. Confidential, Property of Medem, Inc. Subject to NDA Page 2 of 13

Table of Contents 1 INTRODUCTION...5 1.1 About Medem... 5 1.2 Project Overview... 5 1.3 Project Details... 6 1.3.1 Themeing... 6 1.3.2 Content Types... 6 1.3.3 Editorial Workflow Process... 6 1.3.4 Content for Medem.com, Ihealthrecord.org and Medical Library... 6 1.3.5 Architecture... 6 1.3.6 Medical Library Search... 7 1.3.7 Availability of Medical Articles to other applications... 7 1.4 Future Opportunities... 7 2 PROJECT BRIEFS...8 2.1 Key Dates... 8 2.2 High-level Scope of the Engagement... 8 2.3 Expected modus operandi... 9 2.3.1 Development Languages and Technologies... 9 3 RFP RESPONSE DELIVERY INSTRUCTIONS...10 3.1 Vendor Questionnaire... 10 3.1.1 Drupal Knowledge... 10 3.1.2 General Contracting... 10 3.1.3 Industry Knowledge... 11 3.1.4 References... 11 3.2 Submission... 11 3.3 References... Error! Bookmark not defined. 3.4 Appendices... 12 Confidential, Property of Medem, Inc. Subject to NDA Page 3 of 13

3.5 Terms and Conditions... 12 3.5.1 Disclosure... 12 3.5.2 Intellectual Property... 12 3.5.3 Right to Select... 12 3.5.4 Confidentiality... Error! Bookmark not defined. 3.5.5 Release of Information... 12 3.5.6 Right to Amend... 12 3.5.7 Acquisitions and Mergers... 12 3.5.8 Right to Modify... 12 3.5.9 Subcontracting... 13 Confidential, Property of Medem, Inc. Subject to NDA Page 4 of 13

1 Introduction 1.1 About Medem Medem, Inc. is the leading provider of products and services to the Healthcare industry. Medem has created the nation's premier physician-patient communications network, designed to facilitate online access to information and care for more than 90,000 physicians, their practices, and their patients. Medem's services include: An ihealthrecord for all Americans, with integrated Education Programs developed by trusted health authorities including the nation's medical societies, national patient advocacy groups, and government agencies, among others. HIPAA compliant Online Consultation, fee-based clinical consultation service, and Secure Messaging, to handle administrative issues with a physician practice, including scheduling appointments, request prescription renewals, and asking general questions. Physician practice web sites, which provide patients with general practice information, news and announcements, trusted clinical content from the nation's leading medical societies, and access to all secure Medem services that the practice has enabled. 1.2 Project Overview After considering the available technologies and solutions available Medem has decided to use Drupal as its CMS. Medem currently has two web properties that need to come under the management of Drupal, http://www.medem.com and http://www.ihealthrecord.org. Both web sites have integration points with our online products which would need to be maintained. The medem.com web site is currently run using Cold Fusion files which are manually maintained. In addition to the content and design, some functionality would need to be replicated as well. The ihealthrecord.org site is currently run using static HTML files which are manually maintained. Content changes on both sites are currently subject to a lengthy build and QA process since the actual files need to be modified and placed into production. The medem.com web site also features a library of medical articles (http://www.medem.com/medlb/medlib_entry.cfm) and a search for those articles that is shared with other Medem applications. The medical articles are currently maintained by a CMS called Xcelerate which is no longer supported due to the facts that the company has gone out of business and Medem does not have the source code to enhance the product or fix bugs. These medical articles are provided both by third party partners (e.g. the AMA and other medical societies) and by internal resources (e.g. our editorial team). The CMS will need to support a strict editorial process for this type of content. Integration points for the medical library and medical library search will need to be considered during development. Solutions that can be utilized by our suite of java-based web applications will be required. These solutions may be implemented over multiple phases since changes to other applications may be required. Finally, performance and security are of paramount importance to Medem. The aforementioned sites are the primary public face of Medem and therefore should support our current traffic volume and perform well based on expected growth. In the medical software space security is an extremely important topic which can make or break the reputation of a company. This project will Confidential, Property of Medem, Inc. Subject to NDA Page 5 of 13

have several integration points with our other products which need to be considered, but we also publish medical articles which are a trusted source of information for our customers. 1.3 Project Details Formal requirements for this project will be produced before starting design and development activities, the following detailed sections are meant to provide more insight into the project for the purposes of providing an estimate. 1.3.1 Themeing Medem.com and ihealthrecord.org shall operate as two independent sites, so two themes would need to be produced. The content, navigation and design shall be preserved in the templates. However, changes can be entertained where the change would better fit the Drupal paradigm or the change would make the site comply with modern web standards. 1.3.2 Content Types Several content types will need to be created to support Medem business processes. These include things like press releases, news articles, job postings and medical articles. At this time we believe that implementing these in CCK is sufficient. 1.3.3 Editorial Workflow Process We d like to implement an editorial workflow process in Drupal to be used with medical articles. Medical articles may be submitted either by a third party partner (e.g. medical society or pharmaceutical company) or by our internal editorial team. This article should not be published until it has received final approval from the editorial team. Furthermore the existing Drupal limitation of requiring a user to have the administer node permission to view unpublished nodes will not work because it gives that user too much power in the system. The article should walk through multiple approval stages and should appear in a queue so that an individual user in a class of users can assign themselves to the work and managers are able to see how the whole pipeline of work is proceeding. The concept we are going for is similar to the concept of desks in this application: http://www.bricolage.cc/docs/howtos/2004/12/23/workflow/. Implementation of this concept through some combination of available modules such as views, workflow and actions is preferred. However, if that is not feasible a custom module could be created to handle some functions. 1.3.4 Content for Medem.com, Ihealthrecord.org and Medical Library At this time we believe that any content conversion can be handled by Medem resources, this would be out of scope for this project. 1.3.5 Architecture Medem will be purchasing new hardware for this project. Therefore we d like to get some architecture setup recommendations that will help us perform well given the following metrics for the Medem.com site only. 3 month avg, monthly page views: 1,066,495/month 3 month avg, monthly bandwidth: 29.3 GB/month Confidential, Property of Medem, Inc. Subject to NDA Page 6 of 13

1.3.6 Medical Library Search Currently the Medical Library search is built in our cold fusion code. We ll want to implement this same functionality in Drupal, hopefully making use of the search API without having to expand it. You can try a search on the web site but the key items here are that the search would need to score items based on relevance and based on complexity (Introductory health info, General Health Info, Advanced Resources and Professional research). Secondly, the search will need to be available to other Medem applications. Currently this search returns the result set as XML so that it can be used by other applications. 1.3.7 Availability of Medical Articles to other applications Other Medem applications make use of our medical library by offering the library directly or simply by offering certain types of articles. For example, see this physician web site which pulls in medical articles under the patient resources section and the medical news section: http://www.bwfhc.yourmd.com/birnbaum. Each physician has the option of creating a web site like this where they can offer selected articles they feel are relevant to their patients. This effectively means some sort of API needs to be in place to offer these medical articles to other applications. 1.4 Future Opportunities Medem, Inc. will consider expansion of the relationship upon successful progress with the project discussed in this RFP. Options may include maintenance and support for existing Medem products, and future enhancements which would provide CMS access to third parity entities and applications. Confidential, Property of Medem, Inc. Subject to NDA Page 7 of 13

2 Project Briefs 2.1 Key Dates While forecasted dates below are based on our best estimates, actual schedule may vary. It is Medem s strong preference to move faster than the dates below indicate. Task Target Complete Date Release RFP 05/16/2007 RFP responses due from vendors 05/31/2007 Short list / notifications 06/08/2007 Due diligence, reference check and portfolio check 06/15/2007 Finalize vendor and contract negotiation 06/22/2007 Engagement begins 06/27/2007 Assuming a team of resources will be available for project work within seven days of the engagement beginning date, the following timelines are the target. While this forecast is based on our best estimates, actual numbers and schedule may vary. Phase Project Target Start Date Target Duration Phase 1 Phase 2 Phase 3 Phase 4 Project Requirements, Design & Milestones, Theme conversion Static Content Conversion & Editorial Workflow Forms, dynamic components, and integration QA, Acceptance Testing and General Availability 07/09/2007 2 weeks 7/30/2007 1 month 8/1/2007 Phased rollout TBD 1 month 2.2 High-level Scope of the Engagement The engagement covered by this RFP is focused on moving Medem s corporate web presence and editorial workflow from its current ColdFusion-based and Xcelerate-based architecture to lean open-source based content management framework. The scope of the engagement expected to be delivered by the contracted team includes a major portion of the software development lifecycle. In particular for a vast majority of the project components Medem technology team will only be responsible for developing of high level product requirements and final QA and acceptance. Medem technology team will be involved through out Confidential, Property of Medem, Inc. Subject to NDA Page 8 of 13

the rest of the SDLC however its role is presumed to be limited to review and acceptance of interim deliverables and assistance in areas of domain expertise and use of existing frameworks. Exact activities for the contracted team would be defined on a project basis and may include all typical software activities / deliverables ranging from development of requirements to end-user documentation and post launch support. Medem s Drupal project has very aggressive timelines and is expected to produce tangible deliverable in a short term. Medem expects the contracted team to consist of a fully functional, self-sufficient team capable of delivery of the application with limited support from Medem core resources. 2.3 Expected modus operandi Medem expects that engagement is run under a modified waterfall / feature driven development SDLC model with use of some of the best practices introduced by Agile Development approach, for example Test Driven development. Medem expects that main deliverables will include: working software; fully documented source code including database components with revision history; technical documentation and knowledge transfer; Medem expects that contracted team would operate at their own time / holiday schedule, at the same time we assume that all status meetings, conference calls, and other joint activities happen in reasonable workweek hours: 7:30 AM 9 PM PDT. 2.3.1 Development Languages and Technologies Medem utilizes a number of development languages and technologies that include but not limited to the components specified below. The vendor is expected to be able to furnish resources with full proficiency in those areas. Apache Complete knowledge of the Drupal API 5.x and Themeing Knowledge and experience working with high performance Drupal sites PHP XHTML, CSS XML and web services MySQL administration and performance tuning Confidential, Property of Medem, Inc. Subject to NDA Page 9 of 13

3 RFP Response Delivery Instructions 3.1 Vendor Questionnaire The following questions / requests for response must be addressed in order to be considered for this engagement. 3.1.1 Drupal Knowledge 3.1.1.1 How many years of Drupal experience do you have (if multiple developers what is the average)? 3.1.1.2 Provide some examples of your best theming work. Examples should describe and show off innovative use of theming, not great graphic designs. 3.1.1.3 Provide examples of your best custom module development work. What problem were you trying to solve and how did Drupal's framework make that possible? 3.1.1.4 Do you have experience integrating Drupal with other systems either directly or via web services? If so please provide examples. 3.1.1.5 Have you dealt with the challenges of building high performance Drupal sites? If so what were some of those challenges, and what volume of traffic did the client have? 3.1.1.6 Have you had experience designing and automating business processes within Drupal? If so please provide examples. 3.1.2 General Contracting 3.1.2.1 What software development processes do you typically follow when working through the life cycle of a project from client requirements to general availability? 3.1.2.2 When you are working on a project, what types of communication do you typically have with a client and what is the frequency? 3.1.2.3 Do you provide a support/bug fix window after the project is completed? If so how long and under what conditions? 3.1.2.4 Do you prefer to work at a client site or off-site? If off-site, are you available for status meetings between 9:00 AM - 5:00 PM Pacific Standard Time? 3.1.2.5 What is your typical work week in terms of total hours per week, and days of the week on which you are available? 3.1.2.6 What is the earliest date you can begin the engagement? 3.1.2.7 Are you available for all phases of the engagement listed in section 2.1 3.1.2.8 What do you typically require of your clients? Confidential, Property of Medem, Inc. Subject to NDA Page 10 of 13

3.1.2.9 Briefly describe your experience / familiarity with relevant technologies using the table below. H/W or S/W elements PHP CSS MySQL XHMTL Apache Drupal API 5.x Themeing XML Web services Competency (Expert, Know Well, Familiar, No Experience) Years of experience, comments, specific versions if applicable 3.1.3 Industry Knowledge 3.1.3.1 Have you had any experience with medical/healthcare industry? If so, please describe. 3.1.3.2 Have you had any experience designing or maintaining a richly structured content repository (a professional library)? If so, please describe. 3.1.3.3 Can you name several websites (using Drupal framework) you consider similar to Medem's project scope and feature sets as stated in this RFP? What similarities do you see? Please note, these sites do not need to be developed by you. 3.1.4 References 3.1.4.1 Provide three (3) clients we may contact about your work. 3.1.4.2 Provide a portfolio of your work which has illustrates your strengths as they relate to Drupal development. 3.2 Submission Submit proposals in MS Word or Adobe PDF format (attachments, examples, brochures, etc. could be submitted in any of standard Microsoft document formats) to David Aaronson via email (david.aaronson@medem.com) and cc: Raven Brooks (raven.brooks@medem.com). Response to this RFP must cover all areas and questions presented in the Vendor Questionnaire. Medem reserves the right to reject any proposal that does not all of these items. RFP Deadline: Medem reserves the right to reject any proposal received after the deadline date without any consideration. Confidential, Property of Medem, Inc. Subject to NDA Page 11 of 13

3.3 Appendices If applicable, the vendor may include any information that supports their responses to this RFP. 3.4 Terms and Conditions 3.4.1 Disclosure All vendors submitting a proposal must complete and sign a Non-Disclosure Form prior to the beginning of the engagement. 3.4.2 Intellectual Property Medem Software is the intellectual property (IP) of Medem Inc, nothing in this RFP or any subsequent documents, agreements (verbal or written) shall be interoperated to transfer or share those rights. The work product of the proposed conversion project shall also be the IP of Medem and shall not be transferable. 3.4.3 Right to Select Participation in this RFP process in no way obligates Medem, Inc. to pursue a business contract with the supplier or to have the supplier participate in future RFPs. Medem, Inc. reserves the right to reject all proposals without explanation. Medem, Inc. reserves the right to select and negotiate with those suppliers it judges qualified for competitive bidding and to terminate negotiations without incurring any liability. Medem, Inc. reserves the right to award contracts to multiple vendors. Although Medem, Inc. prefers to contract with one or a small number of strategic vendors, final selection for specific statements of work may be awarded as Medem, Inc. sees fit. 3.4.4 Release of Information All information contained herein will remain the property of Medem, Inc. No news release, public announcements, denial or confirmation of any part of this RFP, contract award or any phase of this project will be made by vendor without express written approval of Medem, Inc. 3.4.5 Right to Amend Medem, Inc. reserves the right to issue clarifications and amendments to this RFP at any time. 3.4.6 Acquisitions and Mergers Any organization(s) acquired by or merged into Medem, Inc. will be incorporated into any agreements resulting from this RFP at Medem, Inc. discretion. 3.4.7 Right to Modify Any data contained herein are estimated requirements for the purposes of this RFP. We reserve the right to modify any estimated requirements prior to signing the agreement with the selected supplier. No prospective supplier shall have a claim on us in the event that any estimated requirements are modified. Confidential, Property of Medem, Inc. Subject to NDA Page 12 of 13

You may modify your proposal after its submission by withdrawal and resubmission prior to the due date for proposals. Modifications offered in any other manner, whether written or oral, will not be considered. 3.4.8 Subcontracting No work shall be subcontracted without prior written consent from Medem, Inc. In the event subcontracting is agreed to, Medem, Inc. will not assume any liability for the subcontracted operations. Confidential, Property of Medem, Inc. Subject to NDA Page 13 of 13